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2.
BMC Public Health ; 24(1): 1498, 2024 Jun 04.
Article En | MEDLINE | ID: mdl-38835005

BACKGROUND: In the context of persistent wars and conflicts worldwide, the impact of acute, excessive and constant exposure to media coverage of such events on mental health outcomes becomes a serious problem for public health, and requires therefore urgent investigation to inform an effective prevention and management response. The objective of the present study was to test the hypothesis that war-related media exposure is directly and indirectly associated with insomnia through depression and perceived stress among adults from the general population of different Arab countries. METHODS: A cross-sectional study was carried-out two weeks after the beginning of Israel-Gaza war on the 7th of October 2023. An anonymous online survey and a snowball sampling method were adopted to collect data. A sample of 2635 general population adults (mean age of 23.98 ± 7.55 years, 73.1% females) took part of this study. RESULTS: The results of the mediation analysis showed that, after adjusting over potential confounders, depression and perceived stress fully mediated the association between war media exposure and insomnia; higher war media exposure was significantly associated with higher depression (Beta = 0.13; p < .001) and perceived stress (Beta = 0.07; p < .001), whereas higher depression (Beta = 0.43; p < .001) and perceived stress (Beta = 0.31; p < .001) were significantly associated with higher insomnia. It is of note that war media exposure was not significantly and directly associated with insomnia (Beta = - 0.01; p = .178 and Beta = 0.02; p = .098 respectively). CONCLUSION: The present study is the first to provide evidence that more time spent viewing the horrors of war is significantly associated with insomnia. In addition, symptoms of stress and depression were present as early as two weeks following the beginning of the war, and played a significant role in mediating the association between war media coverage and insomnia. These findings suggest that timely screening for, and management of depression and stress symptoms in clinical and preventive programs might be beneficial for community adults who have been heavily and indirectly exposed to war through media, and present with insomnia.


Depression , Sleep Initiation and Maintenance Disorders , Stress, Psychological , Humans , Female , Male , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/psychology , Cross-Sectional Studies , Adult , Israel/epidemiology , Depression/epidemiology , Stress, Psychological/epidemiology , Young Adult , Middle East/epidemiology , Mass Media/statistics & numerical data , Adolescent , Surveys and Questionnaires , Middle Aged , Warfare
3.
Int J Public Health ; 69: 1607094, 2024.
Article En | MEDLINE | ID: mdl-38835807

Objectives: This study assessed emotion recognition skills in school-age children in wartime conditions in Ukraine. Methods: An online survey based on the concept of basic emotions was administrated to a sample of 419 schoolchildren from Ukraine and a control group of 310 schoolchildren from the Czech Republic, aged 8 to 12. Results: There is no difference in judging the intensity of anger and fear by Ukrainian children, compared with the control group. There is no evidence that the emotions of anger, fear, and sadness were better recognized in the Ukrainian group. Children from Ukraine were better at recognizing positive emotions than Czech children. Conclusion: Increased risks of threats and wartime experience do not impair the accuracy of identification of emotions like fear or the assessment of intensity of basic emotions by children who experience war in Ukraine. Still, it is important to continue studying the long-term consequences of military conflicts in order to deepen the understanding of their impact on human mental functioning.


Emotions , Humans , Ukraine , Male , Female , Child , Czech Republic , Surveys and Questionnaires , Warfare/psychology
4.
PLoS One ; 19(6): e0297483, 2024.
Article En | MEDLINE | ID: mdl-38837939

This article delves into the dynamics of a dyadic political violence case study in Rojava, Northern Syria, focusing on the conflict between Kurdish rebels and ISIS from January 1, 2017, to December 31, 2019. We employ agent-based modelling and a formalisation of the conflict as an Iterated Prisoner's Dilemma game. The study provides a nuanced understanding of conflict dynamics in a highly volatile region, focusing on microdynamics of an intense dyadic strategic interaction between two near-equally- powered actors. The choice of using a model based on the Iterated Prisoner's Dilemma, though a classical approach, offers substantial insights due to its ability to model dyadic, equally-matched strategic interactions in conflict scenarios effectively. The investigation primarily reveals that shifts in territorial control are more critical than geographical or temporal factors in determining the conflict's course. Further, the study observes that the conflict is characterised by periods of predominantly one-sided violence. This pattern underscores that the distribution of attacks, and target choices are a more telling indicator of the conflict nature than specific behavioural patterns of the actors involved. Such a conclusion aligns with the strategic implications of the underlying model, which emphasises the outcome of interactions based on differing aggression levels. This research not only sheds light on the conflict in Rojava but also reaffirms the relevance of this type of game-theoretical approach in contemporary conflict analysis.


Game Theory , Prisoner Dilemma , Violence , Humans , Syria , Violence/psychology , Warfare , Models, Theoretical , Armed Conflicts
5.
Tunis Med ; 102(4): 200-204, 2024 Apr 05.
Article En | MEDLINE | ID: mdl-38746958

INTRODUCTION: Stump hyperhidrosis is a common condition after lower limb amputation. It affects the prosthesis use, and the quality of life of patients. Several case reports tried to prove benefit of using Botulinum toxin in its treatment. AIM: This study was to conduct a larger workforce clinical trial and to demonstrate benefits of botulinum toxin injection in the treatment of stump hyperhidrosis. METHODS: A prospective study was conducted. War amputees who complained of annoying excessive sweating of the stump were included. They received intradermal injection of botulinum toxin A in the residual limb area in contact with prosthetic socket. Abundance of sweating and degree of functional discomfort associated with it were assessed before, after 3 weeks, 6 and 12 months. RESULTS: Seventeen male patients, followed for post-traumatic limb amputation were included in the study. Discomfort and bothersome in relation to Hyperhidrosis did decrease after treatment (p<0,001). Reported satisfaction after 3 weeks was 73,33%. Improvement of prothesis loosening up after 3 weeks was 72,5% [±15,6]. Mean injection-induced pain on the visual analogue scale was 5.17/10 (±1.58). The mean interval after the onset of improvement was 5.13 days [min:3, max:8]. The mean time of improvement was 10.4 months after the injection [min:6, max:12]. No major adverse events were reported following treatment. CONCLUSION: Intradermal injections of botulinum toxin in the symptomatic treatment of stump hyperhidrosis are effective and have few adverse effects. It improves the quality of life of our patients thanks to a better tolerance of the prosthesis.


Amputation Stumps , Amputees , Botulinum Toxins, Type A , Hyperhidrosis , Humans , Hyperhidrosis/drug therapy , Male , Adult , Botulinum Toxins, Type A/administration & dosage , Botulinum Toxins, Type A/adverse effects , Prospective Studies , Artificial Limbs/adverse effects , Injections, Intradermal , Middle Aged , Warfare , Quality of Life , Young Adult , Treatment Outcome
6.
Indian J Med Ethics ; IX(2): 130-135, 2024.
Article En | MEDLINE | ID: mdl-38755772

This article looks at the October 2023 war on Gaza in the context of the effects of wars on healthcare systems. I will begin with a brief historical overview of the so-called Israeli-Palestinian conflict to clarify the special status of the Gaza Strip and the hostilities since October 7, 2023. This will be followed by a description of the major distinguishing characteristic of this war, namely, the systematic assault on the healthcare system. Finally, I will attempt to explain the conduct of this war using a necropolitical lens.


Delivery of Health Care , Humans , Middle East , Israel , Arabs , Warfare , Armed Conflicts , Politics
7.
PLoS One ; 19(5): e0301494, 2024.
Article En | MEDLINE | ID: mdl-38776294

One of the oldest complete suits of European armour was discovered in 1960 near the village of Dendra, in Southern Greece, but it remained unknown whether this armour was suitable for extended use in battle or was purely ceremonial. This had limited our understanding of the ancient Greek-Late Bronze Age-warfare and its consequences that have underpinned the social transformations of prehistoric Europe and Eastern Mediterranean. In a series of archeo-physiological studies, merging knowledge in archaeology, history, human physiology, and numerical simulation, we provide supporting evidence that the Mycenaean armour found at Dendra was entirely compatible with use in extended combat, and we provide a free software enabling simulation of Late Bronze Age warfare. A group of special armed-forces personnel wearing a replica of the Dendra armour were able to complete an 11-hour simulated Late Bronze Age combat protocol that we developed from a series of studies based on the available evidence. Numerical simulation of the thermal exchanges in Late Bronze Age warfare extended this conclusion across different environmental conditions and fighting intensities. Our results support the notion that the Mycenaeans had such a powerful impact in Eastern Mediterranean at least partly as a result of their armour technology.


Computer Simulation , Humans , History, Ancient , Greece , Warfare , Archaeology , Military Personnel/history
8.
PLoS One ; 19(5): e0303023, 2024.
Article En | MEDLINE | ID: mdl-38809820

Truth telling processes, initiatives to prosecute war-time perpetrators, and ex-combatant reintegration are examples of common peacebuilding practices after war. Yet, little is known of how women are affected by peacebuilding initiatives such as these, or how they perceive these initiatives for peace. For many women, peace after war does not bring peace to everyday life; research shows that domestic violence increases during and after war. In addition, some peacebuilding measures have been found to increase risk and insecurity, not least for women. To better understand the interconnections between gender and post-conflict attitudes to peacebuilding, we asked 2,041 women and men in Sri Lanka and Nepal of their views on post-war peace initiatives. In line with our expectations, we find that women are more skeptical than men towards peacebuilding measures that involve increased risk in everyday life, such as truth-telling and coexisting with former adversaries and warring groups reintegrating in local communities. There are no gender differences pertaining to peacebuilding initiatives that take place far away at the national level, for example, concerning accountability or, in the case of Nepal, the peace agreement. Our findings suggest that international peacebuilding practice is blind to the everyday insecurities of women after war. That a basic gendered lens is missing from most peacebuilding designs is both alarming and deeply troubling, but identifying this critical aspect provides the opportunity for imperative change. By shedding light on the challenges women face after war, we hope this article contributes to finding ways to mitigate unknown and unintended side-effects of peacebuilding efforts, and thereby to the development of better, evidence-based peacebuilding practice-of benefit to both men and women.


Warfare , Nepal , Humans , Sri Lanka , Female , Male , Adult , Middle Aged , Young Adult , Attitude
10.
Lancet ; 403(10439): 1837-1838, 2024 May 11.
Article En | MEDLINE | ID: mdl-38735289
11.
12.
BMJ Glob Health ; 9(5)2024 May 22.
Article En | MEDLINE | ID: mdl-38777392

Global rates of armed conflicts have shown an alarming increase since 2008. These conflicts have devastating and long-term cumulative impacts on health. The overriding aim in these conflicts is to achieve military or political goals by harming human life, which is the antithesis of the moral underpinnings of the health professions. However, the profession has rarely taken on a global advocacy role to prevent and eliminate conflicts and wars. To assume such a role, the health profession needs to be aware of the extensive and multiple impacts that wars have on population health. To facilitate this discourse, the author proposes a novel framework called 'The Twelve Dimensions of Health Impacts of War' (or the 12-D framework). The framework is based on the concepts of social and environmental determinants of population health. It has 12 interconnected 'dimensions' beginning with the letter D, capturing the adverse impacts on health (n=5), its social (n=4) and environmental determinants (n=3). For health, the indices are Deaths, Disabilities, Diseases, Dependency and Deformities. For social determinants of health, there are Disparities in socioeconomic status, Displacements of populations, Disruptions to the social fabric and Development reversals. For environmental determinants, there is Destruction of infrastructure, Devastation of the environment and Depletion of natural resources. A relatively simple framework could help researchers and lay public to understand the magnitude and quantify the widespread health, social and environmental impacts of war, comprehensively. Further validation and development of this framework are necessary to establish it as a universal metric for quantifying the horrific impacts of war on the planet and garner support for initiatives to promote global peace.


Public Health , Social Determinants of Health , Humans , Armed Conflicts , Global Health , Warfare
14.
Lancet ; 403(10434): 1309, 2024 Apr 06.
Article En | MEDLINE | ID: mdl-38582552
17.
Soc Sci Med ; 349: 116870, 2024 May.
Article En | MEDLINE | ID: mdl-38631234

Terror Management Theory (Tmt, solomon et al., 1991) claims that individuals use three anxiety buffer mechanisms to regulate their death awareness - cultural worldviews, self-esteem, and proximity seeking. In this article, we use these three TMT anxiety buffers to explain the phenomenon of posthumous sperm retrieval, requested by spouses or parents, usually of young soldiers who died during their military service. Whereas this phenomenon has been known for some time, it increased dramatically in the initial days following the massacre conducted by the Hamas terrorist organization in Israel on October 7, 2023. We claim that this was an immediate reaction to this terror event, which posed a direct, existential threat to those who were exposed to the massacre and the soldiers who defended the country, but also to the entire Israeli society, as well as for Jews around the globe. We use interpretive phenomenology to qualitatively examine the phenomenon of retrieving sperm from dead young men, analyzing the requests to retrieve sperm posthumously as a sign of the need to provide these young men with symbolic immortality, on both personal and national levels. We integrate this explanation with the military ethos and the tendency of Israeli society to endorse familyist and pronatalist values to expand our understanding of this contemporary phenomenon in Israel.


Military Personnel , Sperm Retrieval , Humans , Male , Israel , Military Personnel/psychology , Sperm Retrieval/psychology , Posthumous Conception/psychology , Adult , Anxiety/psychology , Young Adult , Warfare/psychology , Attitude to Death , Terrorism/psychology , Qualitative Research
18.
Front Public Health ; 12: 1366600, 2024.
Article En | MEDLINE | ID: mdl-38645454

Introduction: Statistical data indicate a link between war and the spread of sexually transmitted infections (STIs), then it is necessary to carefully analyze the factors that directly affect the identified pattern in order to overcome this problem. Therefore, the purpose of the study was to systematically analyze the factors that influence the spread of STIs during war. Methods: The study included all original research articles and meta-analyses on the impact of war on the spread of sexually transmitted infections that met the following eligibility criteria: (1) articles published exclusively in English; (2) articles published in the period 2013-2023; (3) studies with quantitative, qualitative or mixed design. The search for relevant literature was conducted using four databases: PubMed, Embase, Web of Science, and Ebsco. Results: The articles selected for our systematic review had different research designs and were mainly published as original studies (n = 8) and literature reviews (n = 6). As a result of the evaluation of the selected articles for the systematic review, the authors identified migration, a decrease in access to health care, difficult access to contraception, sexual violence as the most frequent factors directly affecting the spread of STIs during the war. Conclusion: This systematic review systematizes data on the impact of hostilities on the spread of STIs and outlines the main factors that contribute to the dissemination of pathogens far beyond the territory at the epicenter of the conflict.Systematic review registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023479808, CRD42023479808.


Sexually Transmitted Diseases , Humans , Sexually Transmitted Diseases/epidemiology , Warfare , Risk Factors , Female
19.
Epilepsy Behav ; 155: 109768, 2024 Jun.
Article En | MEDLINE | ID: mdl-38636138

Jordan and Palestine are tightly related countries as the same families live in the two adjacent countries. The present study sought to examine the prevalence and determinants of Post-Traumatic Stress Disorder (PTSD)symptoms, insomnia, and fatigue among a cohort of People with Epilepsy (PWE) in Jordan. This is a cross-sectional study with inclusion criteria. PTSD, insomnia, and fatigue were assessed using validated scales. Data were analyzed from 109 PWE, PTSD symptoms were screened in (35.5 %), and Insomnia was screened in 51.8 %, moreover, fatigue mean score ± SD was 44.64 ± 26.96. PTSD symptoms were significantly associated with "females" and "age above 30 years" Insomnia severity was associated with "females". Also, the regression results demonstrated that "abstinence from social media" was significantly related to lower insomnia severity. Higher fatigue severity was associated with "married" and "Generalized Tonic-Clonic Seizures", whereas, lower fatigue severity was associated with "males", and with "levetiracetam". Our findings indicate the need for actions to alleviate mental health deterioration in PWE.


Epilepsy , Fatigue , Sleep Initiation and Maintenance Disorders , Stress Disorders, Post-Traumatic , Humans , Jordan/epidemiology , Male , Female , Epilepsy/epidemiology , Epilepsy/psychology , Epilepsy/complications , Adult , Prevalence , Fatigue/epidemiology , Fatigue/etiology , Fatigue/psychology , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/psychology , Middle Aged , Stress Disorders, Post-Traumatic/epidemiology , Cross-Sectional Studies , Young Adult , Warfare
20.
Environ Manage ; 73(6): 1089-1093, 2024 Jun.
Article En | MEDLINE | ID: mdl-38649482

The military-industrial complex, military operations, and wars are major contributors to exacerbating both climate change and biodiversity crises. However, their environmental impacts are often shadowed due to national security reasons. The current paper aims to go through the devastating impacts of military operations and wars on climate change and biodiversity loss and challenges that hinder the inclusion of military-related activities into environmental crisis mitigation efforts. The information blind spot induced by concerns about national security reasons jeopardizes the efforts to involve the military-industrial complex and military operations in the global climate and biodiversity agendas. Besides that, many military-related challenges, such as specificity of operational requirements and lifecycles, dependence on fossil fuels, complex supply change, inadequate civilian technologies and innovations, and requirements of structural changes, can hinder emission reduction. Meanwhile, wars and conflicts not only threaten to drain all human and material resources available to tackle environmental problems but also inflict long-lasting destructions, pains, and trauma that can lead to hatred and distrust among nations and parties. With the rising hatred and distrust, global agreement and commitment to address climate change and biodiversity will hardly be achieved. Thus, promoting peace is the humanistic and planetary conscience.


Biodiversity , Climate Change , Conservation of Natural Resources/methods , Humans , Warfare , Military Personnel
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